Home and Community Based Care: Experiences from Different Settings

The Samraksha project provides a range of care and support services for people with HIV/AIDS and their families in Bangalore and surrounding areas. It provides counselling, support in the outpatient clinic, home-based care, self-help groups and respite care. The program is designed and modified according to the stated needs of people with HIV/AIDS and their families. The focus of this project is to place the person and their family at the centre of care and to provide a broad range of care and support options for them to choose from. For instance, a single mother with HIV chooses to access most of her care from the outpatient services rather than stay in hospital, as she cannot leave her child unattended at home. The main points in this presentation were that care and support options for people with HIV/AIDS ands their families are expanded when the thrust of service planning is to complement existing services and build the strength of existing services to take on the care of people with HIV/AIDS. Increasing options for people has several advantages. It gives them an increased sense of control, leading to better coping; it increases wellbeing by allowing people to locate their care in the setting that best suits their needs. It also increases security as people can access the full range of mainstream services. This approach means that the pool of available carers and care services is significantly broadened. It ensures that all health care workers and facilities take on a responsibility to make their services HIV friendly and accessible. It demystifies HIV/AIDS care and brings the maximum resources to the task. It focuses on filling gaps in existing services rather than setting up a series of new services. Ms Iyengar also described of the process of bringing mainstream services to a better understanding of the needs of people with AHIV/AIDS and their families. Samraksha has taken a very gentle approach to this work, sending volunteers into outpatient services to act as additional supporters. The interaction between these volunteers and the staff of the mainstream services has resulted, over time, in an increased capacity of the mainstream services to fully understand the needs of the people with HIV/AIDS and their families.